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经股动脉主动脉瓣植入相关血小板减少症的趋势

Trends in Transfemoral Aortic Valve Implantation Related Thrombocytopenia.

作者信息

Abu Khadija Haitham, Gandelman Gera, Ayyad Omar, Poles Lion, Jonas Michael, Paz Offir, George Jacob, Blatt Alex

机构信息

Heart Center, Kaplan Medical Center, Rehovot 76100, Israel.

Mediciene Faculty, Hebrew University, Jerusalem 91120, Israel.

出版信息

J Clin Med. 2022 Jan 29;11(3):726. doi: 10.3390/jcm11030726.

Abstract

BACKGROUND

TAVI related thrombocytopenia (TAVI-rTP) is still very common. The aim of this study was to compare the incidence, characteristics and impact of reduced platelet counts (RPC) after TAVI between an earlier and contemporary period.

METHODS

the patients enrolled were those experiencing severe symptomatic aortic stenosis who underwent TAVI between January 2010 and December 2019. The exclusion criteria were no available blood tests and periprocedural death.

RESULTS

334 patients (mean age 81.9 ± 6.7 years) were enrolled. For the earlier period, the mean RPC was 33 ± 15%, and in the contemporary period (2016-2019) it was 26 ± 14%. In the early group, we found that 62% of the patients had decreased platelet counts of more or equal to 30% in comparison to 33% in the contemporary period. The time of the procedure and the amount of the contrast that had been used in the later period were associated with significant RPCs ( value = 0.002 and 0.028, respectively). An RPC of 30% or more was associated with the increased risks of life-threatening bleeding, vascular complications and death within 30 days.

CONCLUSION

contemporary TAVI-rTP continued to be a common phenomenon in our cohort. However, severe thrombocytopenia was significantly less frequent. An RPC of 30% or more is associated with a poor 30-day outcome.

摘要

背景

经导管主动脉瓣置入术相关血小板减少症(TAVI-rTP)仍然非常常见。本研究的目的是比较早期和当代经导管主动脉瓣置入术后血小板计数降低(RPC)的发生率、特征及影响。

方法

纳入2010年1月至2019年12月期间接受经导管主动脉瓣置入术的重度症状性主动脉瓣狭窄患者。排除标准为无可用血液检测结果及围手术期死亡。

结果

共纳入334例患者(平均年龄81.9±6.7岁)。早期平均RPC为33±15%,当代(2016 - 2019年)为26±14%。早期组中,62%的患者血小板计数降低≥30%,而当代这一比例为33%。后期手术时间及造影剂用量与显著的RPC相关(分别为P值 = 0.002和0.028)。RPC≥30%与30天内危及生命的出血、血管并发症及死亡风险增加相关。

结论

当代TAVI-rTP在我们的队列中仍然是一种常见现象。然而,严重血小板减少症的发生率显著降低。RPC≥30%与30天不良预后相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0266/8836837/a6d7d4ae654e/jcm-11-00726-g001.jpg

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